• Mohammad Jawad
  • Aqil -ur-Rehman Nadeem
  • Aleem ul Haq Khan
  • Mohammad Aftab


Background: The weak zonule’s predisposition to complications during conventional cataractsurgery is one of the common risk factor for poor visual acuity after surgery. The present studywas conducted to determine the frequency and types of complications during cataract surgery inpatients with Pseudoexfoliation Syndrome. Methods: A cross sectional descriptive study based onnon probability sampling of patients having pseudoexfoliation syndrome admitted for cataractsurgery in tertiary care hospitals was carried out spread over 4 years. The data of all variables ofinterest were entered and analyzed through SPSS version 15.0. Results: A total of 200 eyes of 122patients having Psuedoexfoliation were included in the study. Vitreal prolapse in 21 (10.5%) andposterior capsular rupture in 18 (9%) patients were the most common complications seen inPseudoexfoliation. Damage to sphincter pupillae in 16 (8%), iridodialysis in 2 (1%), decentrationof IOL in 8 (4%) and hyphaema in 2 (1%) patients was seen. Zonular dialysis in 8 (4%), retainedlens matter in 12 (6%) and lens dislocation was seen in 6 (3%) patients. Conclusion: Patients withpseudoexfoliation are at increased risk for development of complications. Ophthalmologistsshould stress to increase awareness among general public for the proper diagnosis and convincepatients for proper and regular follow up visits to the hospital.Keywords: Pseudoexfoliation, Cataract, Complications, Intraocular pressure


Kanski JJ. Glaucoma. In: Kanski JJ. Ed. Clinical ophthalmology.

th ed. London: Butterworths Heinemann; 2007:371–440.

Shafiq I, Sharif-ul-Hasan K. Prevalance of pseudoexfoliation

(PEX) Syndrome in a given population. Pak J Ophthalmol


Lindberg JG. Clinical investigations on depigmentation of the

pupillary border and translucency of the iris in cases of senile

cataract and in normal eyes in elderly persons. Acta

Ophthalmol 1989;190:1–96.

Vogt A. Ein neues Spaltlampenbild des Pupillengebietes.

Hellblauer Pupillensaumfilz mit Hautchenbildung auf der

Linsenvorderkapsel. Klin Monatsabl Augenheilkd 1925;75:1–12.

Cebon L, Smith RH. Pseudoexfoliation of the lens capsule

and glaucoma. Br J Ophthalmol 1976;60(4):279–82.

Rao RQ, Arain TM, Ahad MA. The prevalence of

pseudoexfoliation syndrome in Pakistan. Hospital based

study. BMC Ophthalmol 2006;6:27.

Arvind H, Raju P, Paul PG, Baskaran M, Ramesh SV, George

RJ, et al. Pseudoexfoliation in South India. Br J Ophthalmol


Young AL, Tang WW, Lam DS. The prevalence of

pseudoexfoliation syndrome in Chinese people. Br J Ophthalmol


Ringvold A. Epidemiology of the pseudoexfoliation

syndrome. Acta Ophthalmol Scand 1999;77:371–5.

Tayler HR. Pseudoexfoliation syndrome; an environmental

disease. Trans Ophthalmol Soc UK 1979;99:302–7.

Duke-Elder S: Diseases of the lens and vitreous. In DukeElder S ed. System of Ophthalmology Vol-XI. St. Louis: The

CV Mosby and Company; 1969. p.47–57.

Baig MA, Niazi MK, Karamat S. Pseudoexfoliation

syndrome and secondary cataract. Pak Armed Forces Med J


Naeem S. Incidence, age of presentation and lenticular

changes in exfoliation syndrome. [Dissertation]. Karachi:

College of Physicians & Surgeons;1997:149.

Naseem A. Cataract surgery in patients with

pseudoexfoliation. [Dissertation]. Karachi: College of

Physicians & Surgeons;2002:111.

Khanzada AM. Exfoliation syndrome in Pakistan. Pak J

Ophthalmol 1986;2:7–9.

Katsimpris JM, Petropoulos IK, Apostolakis K, Feretis D.

Comparing phacoemulsification and extracapsular cataract

extraction in eyes with pseudoexfoliation syndrome, small

pupil, and phacodonesis. Klin Monatsbl Augenheilkd


Akman A, Yilmaz G, Oto S, Akova YA. Comparison of

various pupil dilatation methods for phacoemulsification in

eyes with a small pupil secondary to pseudoexfoliation.

Ophthalmology 2004;111:1693–8.

Parmar P, Salman A. Anterior "lenticonus" in exfoliation

syndrome. Indian J Ophthalmol 2005;53(3):193–4.

Potocky M. The pseudoexfoliative syndrome and its

significance in cataract surgery Cesk Slov Oftalmol

;59(6):422–32. [Article in Slovak]

Dickinson PJ, Greven CM. Avoiding and managing the

dislocated crystalline lens. Compr Ophthalmol Update


Hohn S, Spraul CW, Buchwald HJ, Lang GK. Spontaneous

dislocation of intraocular lens with capsule as a late

complication of cataract surgery in patients with

pseudoexfoliation syndrome. Klin Monatsbl Augenheilkd

;221(4):273–6. [Article in German]

Ang GS, Whyte IF. Effect and outcomes of posterior capsule

rupture in a district general hospital setting. J Cataract Refract

Surg 2006;32(4):623–7.

Chan FM, Mathur R, Ku JJ, Chen C, Chan SP, Yong VS, et

al. Rates of posterior capsule rupture during cataract surgery

among different races in singapore. Ann Acad Med Singapore


Susic N, Brajkovic J. The prevalence of pseudoexfoliation

syndrome in patients admitted for cataract surgery to the

department of ophthalmology, Sibenik General Hospital. Acta

Med Croatica 2006;60(2):121–4. [Article in Croatian]